Provider Demographics
NPI:1750155800
Name:HIRSHON, JORDAN (LMHC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:HIRSHON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6527
Mailing Address - Country:US
Mailing Address - Phone:516-880-4816
Mailing Address - Fax:
Practice Address - Street 1:928 BROADWAY STE 305
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-8153
Practice Address - Country:US
Practice Address - Phone:212-807-8690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014082101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health